Journal
BMC MEDICINE
Volume 19, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12916-021-02064-8
Keywords
Retinal nerve fiber layer; Glaucoma; Biomarkers; Renal function; Optical coherence tomography; Lipid profile; LDL cholesterol; HDL cholesterol; eGFR; Cystatin C; Apolipoprotein B; Apolipoprotein A1
Categories
Funding
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University (EU)
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University (European Social Fund)
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University (Free State Saxony's excellence initiative) [713-241202, 14505/2470, 14575/2470]
- Lions Foundation
- Grimshaw-Gudewicz Foundation
- Research to Prevent Blindness
- BrightFocus Foundation
- Alice Adler Fellowship
- NIH [K99EY028631, R21 EY030142, R21EY030631, R01EY030575]
- NEI [P30EYE003790]
- German Federal Ministry of Education and Research i:DSem -Integrative data semantics in systems medicine [031L0026]
- Novo Nordisk postdoctoral fellowship
- Karolinska Institutet, Stockholm, Sweden
- Karolinska Institutet Research Foundation grant
- Swedish Kidney Foundation (Njurfonden)
- Stiftelsen Stig och Gunborg Westman
- EFSD Mentorship Programme - AstraZeneca
- Strategic Research Program in Diabetes at Karolinska Institutet (Swedish Research Council) [2009-1068]
- Karolinska Institute
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University (European Regional Development Fund)
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In a large population-based study, markers of renal function and lipid metabolism were found to be predictors of sectoral cpRNFLT, showing significant associations independently of other established covariates. In contrast, factors such as markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity did not show significant associations with cpRNFLT.
Background Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. Methods The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and ocular imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. Results In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. Conclusions Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT.
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